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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands | 3 Months Ended
--- | ---
Mar. 31, 2026 | Mar. 31, 2025
OPERATING ACTIVITIES |  |
Net loss | $ (10,687) | $ (10,659)
Adjustments to reconcile net loss to net cash used in operating activities: |  |
Depreciation and amortization | 5,721 | 5,048
Stock-based compensation | 3,982 | 3,859
Accretion of acquisition installment payable | 72 | 62
Deferred income taxes | (314) | 196
Non-cash other | 50 | 139
Changes in certain operating assets and liabilities: |  |
Accounts receivable - trade | (183) | (1,497)
Inventories | 139 | (1,906)
Prepaid expenses and other current assets | (483) | (519)
Accounts payable - trade | 704 | 5,207
Accrued expenses and other liabilities | (3,571) | (2,528)
Other | 1,283 | (1,558)
Net cash used in operating activities | (3,287) | (4,156)
INVESTING ACTIVITIES |  |
Other acquisitions, including clinics, net of cash acquired | (6,777) | (220)
Sale of short-term marketable securities | 5,000 | 0
Investment in private companies and purchases of licenses | (250) | (1,540)
Purchases of property and equipment | (1,760) | (4,227)
Net cash used in investing activities | (3,787) | (5,987)
FINANCING ACTIVITIES |  |
Payments on mortgage notes | (41) | (39)
Payments on acquisition notes | (573) | (87)
Net cash used in financing activities | (614) | (126)
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 313 | (79)
NET DECREASE IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH | (7,375) | (10,348)
Cash, cash equivalents and restricted cash, beginning of year | 21,620 | 45,777
Cash, cash equivalents and restricted cash, end of period | 14,245 | 35,429
SUPPLEMENTAL DISCLOSURES |  |
Cash paid for interest | 1,869 | 1,269
Transfer of instruments between property and equipment and inventory | (126) | (461)
Right-of-use assets obtained in exchange for lease liabilities | 793 | 1,682
Debt issuance costs not yet paid | 289 | 0
LOC Acquisition |  |
SUPPLEMENTAL DISCLOSURES |  |
Issuance of common shares in connection with Boston O&P acquisition | 257 | 0
Boston Brace International, Inc |  |
SUPPLEMENTAL DISCLOSURES |  |
Issuance of common shares in connection with Boston O&P acquisition | $ 0 | $ 233

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